UNDATED Only about 150 patients get lung transplants every year, while many more are
left waiting.
The life-saving discovery is a machine that keeps people going, even after their lungs have given up.
It's
not permanent fix, but it is a 'bridge' that is carrying some patients until a
transplant is possible.
Every breath is a gift
for
Liesbeth Stoeffler. The former marathon runner, who now pounds the pavement, had lung transplant.
It is now seven months after her lung transplant and she is in good health, but
that life-saving surgery might not have happened without the breathing machine.
"I would not have made it through, because I was getting very, very ill,"
said Stoeffler.
Stoeffler had end-stage cystic fibrosis. Doctors feared a traditional ventilator
would damage her lungs even more as she waited for a transplant. Instead, they
hooked her up to an Ecmo machine, typically used for babies with
breathing problems.
Tubes connected to veins in the patient's neck and groin. Instead of pushing air
into the lungs, like a ventilator, the machine bypasses them and directly
oxygenates the blood.
"A patient who's on full support with Ecmo flow really doesn't need the heart
and lungs to work at all, and can rest them fully," explained Doctor Mark Hudak
of the University of Florida.
Stoeffler's doctors at New York Presbyterian Hospital-Columbia adjusted the
machine to allow her to stay awake, move and even eat. The goal was to keep her strong
enough to make it to a transplant.
Stoeffler says the machine helped her tremendously.
"I was texting. I was e-mailing. I was so busy the nurses came to take blood
and I
had to tell them to use this hand because I needed this hand for texting. I
never let go!"
The device served as a bridge for 18 days, until the call came saying that healthy lungs
were available.
Stoeffler has had a smooth recovery.
"Now I'm doing great. It's just awesome. I've been able to run and go to the
park."
Just
seven months later, Stoeffler is working on gaining weight, muscle and a new
sense of freedom.
"I just gave it my all, and that's what I'm doing now."
Doctors are using ECMO technology as both a bridge to transplant and a bridge to
recovery. It also works helping patients with H1N1, COPD and pneumonia.
BACKGROUND: Cystic fibrosis is an inherited chronic disease that causes the body
to produce unusually thick, sticky mucus. A defective gene and its protein lead
to the disease, which affects 30,000 children and adults in the United States,
according to the cystic fibrosis foundation. Cystic fibrosis causes the lungs
to clog, which leads to life-threatening lung infections. The condition also
obstructs the pancreas and stops natural enzymes from helping the body digest
food. While 50 years ago most children died before reaching elementary school,
treatments now allow many people with the disease to live into their forty's and
beyond.
KEEPING LUNGS WORKING: Most deaths from cystic fibrosis occur as a result of
lung complications. Lung problems caused by the condition include chronic
infection, damaging of the airways, and collapsed lung. Over time, cystic
fibrosis can damage lung tissue so badly that it doesn't work anymore. At this
point, doctors may suggest a lung transplant -- a major operation since both
need to be replaced. About 900 lung transplants are performed in the United
States each year, and nearly 1,600 people with cystic fibrosis have received
lung transplants since 1991.
A patient waiting on a lung transplant may need respiratory support from a
ventilator. Some patients have lung damage so severe that the ventilator itself
can do further damage. A ventilator applies positive pressure to the lungs,
which is an abnormal event for the organ, as normal breathing applies negative
pressure. To solve the dilemma, some medical centers offer extracorporeal
membrane oxygenation (ECMO) to keep the blood oxygenated without a ventilator as
a bridge to transplant. ECMO works by bypassing the lungs to directly oxygenate
the blood. The ECMO circuit draws blood from the body, circulates it through an
oxygenator, removes carbon dioxide, warms the blood and returns it to the
circulatory system.
FOR MORE INFORMATION, PLEASE CONTACT:
Department of Thoracic Surgery
New York-Presbyterian Hospital/Columbia
(212) 305-7771
